[Optimizing long-term anticoagulation by patient self-management?].

Abstract

An active role of the patient in managing his own therapy leads to an optimized quality of long-term anticoagulation and to a reduction of hemorrhagic or thromboembolic complications of treatment. Our study shows that patients could be easily trained in the self-management of oral anticoagulation and that they achieve superior anticoagulation control. In 10 years 1244 patients were trained in the self-management of oral anticoagulation at the Cardiac Rehabilitation Center in Bad Berleburg, Germany. With regard to their self-determined prothrombin times (PT) 387 patients could be followed up. The results were within the target range in 81.5% of the PT measurements taken by the patients themselves. Only 18.5% PT's were outside of the target range. The incidence of more important bleedings was 0.33% per year and of thromboembolic complications was 0.25% per year. Self-management of oral anticoagulation is associated with a reduced risk of hemorrhagic and thromboembolic complications and an improvement of prognosis and quality of life.